{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:36:17Z","timestamp":1787160977554,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Echocardiography is central to the diagnosis of infective endocarditis (IE). Although guidelines recommend repeating echocardiography when clinical suspicion persists despite negative or inconclusive findings, the diagnostic value of repeating transthoracic echocardiography (TTE) remains uncertain. The aim was to evaluate the diagnostic performance of repeat TTE in the diagnosis of IE among patients with suspected IE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This retrospective study conducted at Lausanne University Hospital (2015\u20132024) including adult patients with suspected\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">IE<\/jats:styled-content>\n                      who underwent 2\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">TTEs<\/jats:styled-content>\n                      within 21\u2009days.\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">IE<\/jats:styled-content>\n                      was classified according to the 2023 Duke\u2010\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">International Society for Cardiovascular Infectious Diseases<\/jats:styled-content>\n                      criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 503 episodes were included, of which 254 (50%) were diagnosed as IE. The second TTE was performed within 8\u2009days from first TTE (interquartile range, 5\u201313\u2009days). The second TTE identified new vegetations in 34 (7%) episodes and new paravalvular complications in 17 (3%) episodes. Sensitivity for detecting vegetations increased from 47% (95% CI, 39%\u201356%) for the first TTE to 57% (95% CI, 48%\u201365%) for the second. By excluding the results of cardiac imaging modalities other than TTE, the sensitivity of the second TTE for diagnosing IE was higher (45% [95% CI, 38%\u201351%]), compared with 34% (95% CI, 28%\u201341%) for the first TTE; the second TTE led to reclassification from possible to definite IE in 7 (1%) of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Repeat\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">TTE<\/jats:styled-content>\n                      modestly improved typical\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">IE<\/jats:styled-content>\n                      lesion detection; however, within a multimodality imaging strategy, its incremental diagnostic contribution was limited. These results suggest that repeated\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">TTE<\/jats:styled-content>\n                      alone is unlikely to substantially alter diagnosis in most patients, supporting the use of complementary imaging when suspicion of\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">IE<\/jats:styled-content>\n                      remains high.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.050020","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T03:41:38Z","timestamp":1786160498000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Diagnostic Performance of Repeat Transthoracic Echocardiography Within a Multimodality Imaging Approach in Patients With Suspected Infective Endocarditis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-8887","authenticated-orcid":false,"given":"Georgios","family":"Tzimas","sequence":"first","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3083-7333","authenticated-orcid":false,"given":"Pierre","family":"Monney","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8466-7360","authenticated-orcid":false,"given":"Panagiotis","family":"Antiochos","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-6208","authenticated-orcid":false,"given":"Denise","family":"Auberson","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta","family":"Ianculescu","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6526-0714","authenticated-orcid":false,"given":"Benoit","family":"Guery","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4453-5202","authenticated-orcid":false,"given":"Lars","family":"Niclauss","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-7578","authenticated-orcid":false,"given":"Matthias","family":"Kirsch","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-5105","authenticated-orcid":false,"given":"Matthaios","family":"Papadimitriou\u2010Olivgeris","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital and University of Lausanne","place":["Lausanne, Switzerland"]},{"name":"Hospital of Valais and 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